Autograft cellular composition and outcome in myeloma patients : results of the prospective multicenter GOA study
Turunen, Antti; Silvennoinen, Raija; Partanen, Anu; Valtola, Jaakko; Siitonen, Timo; Putkonen, Mervi; Sankelo, Marja; Pyörälä, Marja; Kuittinen, Taru; Penttilä, Karri; Sikiö, Anu; Savolainen, Eeva-Riitta; Mäntymaa, Pentti; Pelkonen, Jukka; Varmavuo, Ville; Jantunen, Esa (2021-06-18)
Turunen, A, Silvennoinen, R, Partanen, A, et al. Autograft cellular composition and outcome in myeloma patients: Results of the prospective multicenter GOA study. Transfusion. 2021; 61: 1830– 1844. https://doi.org/10.1111/trf.16424
© 2021 The Authors. Transfusion published by Wiley Periodicals LLC. on behalf of AABB. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
https://creativecommons.org/licenses/by-nc/4.0/
https://urn.fi/URN:NBN:fi-fe202201179012
Tiivistelmä
Abstract
Background: Autologous stem cell transplantation (auto-SCT) is a widely used treatment option in multiple myeloma (MM) patients. The optimal graft cellular composition is not known.
Study design and methods: Autograft cellular composition was analyzed after freezing by flow cytometry in 127 MM patients participating in a prospective multicenter study. The impact of graft cellular composition on hematologic recovery and outcome after auto-SCT was evaluated.
Results: A higher graft CD34⁺ cell content predicted faster platelet recovery after auto-SCT in both the short and long term. In patients with standard-risk cytogenetics, a higher graft CD34⁺ count (<2.5 × 10⁶/kg) was linked with shorter progression-free survival (PFS; 28 vs. 46 months, p = 0.04), but there was no difference in overall survival (OS) (p = 0.53). In a multivariate model, a higher graft CD34⁺CD133⁺CD38⁻ (>0.065 × 10⁶/kg, p = 0.009) and NK cell count (%gt;2.5 × 10⁶/kg, p = 0.026), lenalidomide maintenance and standard-risk cytogenetics predicted better PFS. In contrast, a higher CD34+ count (>2.5 × 10⁶/kg, p = 0.015) predicted worse PFS. A very low CD3⁺ cell count (≤20 × 10⁶/kg, p = 0.001) in the infused graft and high-risk cytogenetics remained predictive of worse OS.
Conclusions: Autograft cellular composition may impact outcome in MM patients after auto-SCT. More studies are needed to define optimal graft composition.
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